The present invention relates to electrical medical leads generally and more particularly to implantable cardiac pacing and defibrillation leads.
Over the years, numerous leads have been designed for the purpose of pacing the atria. One basic approach has been to provide the lead with a pre-formed "J"-shape, adapted to result in the electrode at the tip of the lead being reliably located in the right atrial appendage. Various approaches to providing a J-shaped lead have included the provision of molded, curved polyurethane lead bodies or sheaths as in U.S. Pat. No. 4,394,866 issued to Hughes and U.S. Pat. No. 4,627,439 issued to Harris, curved silicone rubber sheaths as in U.S. Pat. No. 4,402,328 issued to Doring, curved coils as in U.S. Pat. No. 4,402,330 issued to Lindemans, and curved reinforcing wires as in U.S. Pat. No. 4,454,888 issued to Gold. Such curve providing structures are incorporated in the distal portion of the lead so that it maintains a J-shaped configuration after implant, allowing the electrode to continue to resiliently engage the right atrial appendage until such time as it is anchored in place by means of fibrotic tissue growth.
Pacing the atria has also been accomplished by means of electrode leads located in the coronary sinus. One of the earlier coronary sinus leads is the Medtronic, Inc. Model 6992 Coronary Sinus Lead which has a generally straight lead body, carrying two ring electrodes. More recently, leads having pre-formed curved configurations have been employed for pacing and/or mapping the electrical activity of the atria, including U.S. Pat. No. 5,423,772 issued to Lurie, U.S. Pat. No. 5,387,233 issued to Alferness et al., and pending, commonly assigned U.S. Pat. No. 5,683,445 to Swoyer for a "Medical Electrical Lead", incorporated herein by reference in its entirety. An additional design for a curved coronary sinus lead is disclosed in commonly assigned co-pending application No. 08/695,977, filed Jul. 17, 1997 by Sommer et al for a "Medical Electrical Lead", also incorporated herein by reference in its entirety. Coronary sinus leads have also been used to pace and sense the ventricle by advancing the electrode into the great cardiac vein and as part of implantable defibrillation lead systems.